Health and Welfare Summary Plan Description
12.1 Claims and Appeals for Self-Funded PPO, Dental, Vision, LTD and Other Noninsured Benefits.
If you believe you are entitled to Self-Funded PPO benefits (Article VIII), dental benefits (Section 11.1), vision benefits (Section 11.2), long-term disability benefits (Section 11.3), death benefits (Section 11.7) or other non-insured benefits under the Plan, and the Plan refuses to provide these benefits to you, you should file a claim for benefits (and potentially an appeal, if that claim is denied) in accordance with the claim and appeal procedures described in Appendix C. The claim and appeal procedures of the HMOs do not apply to benefit claims relating to benefits described in the preceding sentence. Because the passage of time may limit or eliminate your right to claim benefits, do not delay filing a claim if you believe benefits are owed to you that the Self-Funded PPO has refused to pay.